Systems and methods for treatment adherence in substance abuse treatment

ABSTRACT

Patients with substance abuse problems may be prescribed regular medication that dulls the positive effects of the substance. However, one of the largest challenges for substance abuse patients is that many do not regularly take their medication as they want to experience the high of the substance. Accordingly, systems and methods have been developed for medication sessions that distract the patient from taking the medicine by incorporating the reminder and other med actions in close temporal proximity.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims priority to U.S. Provisional Application No.62/438,083 filed Dec. 22, 2016, the contents of which are incorporatedherein by reference.

FIELD

The present invention is directed to systems and methods for treatmentof substance abuse including drug and alcohol disorders.

BACKGROUND

The following description includes information that may be useful inunderstanding the present invention. It is not an admission that any ofthe information provided herein is prior art or relevant to thepresently claimed invention, or that any publication specifically orimplicitly referenced is prior art.

Treatment of alcohol abuse disorder and other drug addictions is donetoday at rehab centers where a patient is locked into a substance-freefacility for a month or more. Other services may be provided by therehab center, such as a 12-step program, education sessions, or talktherapy. These patients are stabilized by ensuring the addictivesubstance is unavailable for the duration of the program.

Addiction is characterized by the formation of trigger circuits in thebrain which induce a craving for the addictive substance in the addictwhenever the trigger behavior recurs. These trigger circuits are learnedresponses to otherwise-innocuous behaviors which the addict hasfrequently engaged in while using the addictive substance. An example ofa trigger behavior for a smoker might be the completion of a meal, afterwhich he habitually goes out for a smoke. The addictive substance (inthis case nicotine) activates motivational neurotransmitters in thebrain every time the substance is used, thereby building a memorypathway around the trigger behavior (completion of the meal). When thetrigger behavior recurs, the trigger pathway floods the brain withmotivational neurotransmitters that cause a craving for the addictivesubstance.

When the addict leaves rehab, his behavior triggers provide theprincipal challenge. The drug-free stay in the locked rehab environmentwill certainly have improved an addict's health, but it provides littlehelp against those powerful urges for drug use that await in the homeenvironment.

SUMMARY

A far better approach to treating addiction is to treat the addict inthe home environment, where the behavioral triggers are present duringthe treatment program. Provided that the drug use can reliably bereduced or eliminated in the home environment, the addict can begin tolive out different scenarios for the trigger behaviors associated withhis addiction. This type of treatment program can use theneurophysiology of addiction in reverse, to begin to undo the addictionitself. New examples of the trigger behaviors that occur without druguse progressively weaken the addictive association. Maintaining such ahome treatment program for an extended period of time can help addictsmake real progress in regaining control of their addiction.

Of course, the simple locked-door policy of the rehab world will notwork in the home environment, so a more effective treatment methodologyneeds to be used. In the case of addictions for alcohol and opiates,medicines are available that reduce drug use dramatically. For thoseaddicts with a motivation to stop, these medications often allow acomplete cessation of drug use while under medication. If these drugsare taken regularly, a home treatment program can accomplish significantprogress for many patients, not just by reducing drug use for a periodof time, but also by relearning new behaviors that create a more healthylifestyle that can be maintained over the long term.

One of the keys to achieving this outcome is maintaining regularmedication use during a treatment program where the patient is stillbeing exposed to the full load of temptations built into his addictivelifestyle. There is a need for an adherence method of ensuring thatmedications are taken in the home environment despite the presence oftemptations to cheat.

Many adherence methods have been tried, with spotty success. The biggestproblem seems to be that if the patient, challenged by the difficultiesof changing his habits, lacks powerful motivations supporting theaddiction treatment, he will find ways to subvert the intervention.Excuses, in this case temporary narratives that support noncompliancewith a treatment program, can be powerful barriers to a patients'success. These narratives act by enhancing attention to negativebehaviors including not taking daily medications, and avoiding personalinteractions with supporters who encourage behavior change.

Medical personnel are often frustrated by patients who could benefitfrom taking their medication, yet who nonetheless persist in skippingtheir doses. There is a substantial literature that has developed on thesubject of adherence. Reasons for non-adherence cover a huge range fromsimple neglect, as in an aged person not paying enough attention orbecoming confused about medications have already been taken or what dayof the week it is today, to active resistance, as in patients who refusemedicines based on ideas of persecution.

Methods for overcoming non-adherence to medication instructions rangefrom rational persuasion (it's good for you) to gamification (it's fun)and rewards (it's profitable). Our insight is that these approachessuffer from the common difficulty that they tend to emphasize the act oftaking the medications. If the patient can develop an excuse thatsubverts the persuasion, however temporarily, the very efforts atachieving adherence instead accomplish the opposite. The disclosedtechnology is based upon the opposite approach: de-emphasize themedicine and find a way to distract the attention of the patient onanother “shinier” object, while creating the conditions that willnaturally lead to taking the medicine.

The disclosed technology was developed in the difficult field ofaddiction medicine, where it is notoriously hard to obtain co-operationof patients in taking their medicines because those medicines typicallyreduce the pleasure derived from taking the drugs the patients areaddicted to. Nevertheless, we have observed good success with patientsusing our novel adherence methodology.

The disclosed systems and methods provide medication reminders in thecontext of situations where the patient's attention is drawn by adifferent objective, whose purpose is different from that of themedications. Because of the distraction coming from a differentdirection, the patient complies with the reminder while accomplishingthe other objective. For example, in the case of alcohol addiction, thepatient may be prescribed a daily dose of 50 mg of the inexpensive drugNaltrexone.

This drug is FDA approved for use in alcohol addiction, is safe, and hasfew side effects. Yet it diminishes the patients' pleasure from bingingon alcohol so there is definitely a compliance issue which interfereswith adherence. We are finding good adherence results with a mobile appthat reminds patients to take their medicine while occupying them with adifferent task: measuring their blood alcohol content with a personalwireless breathalyzer.

The breathalyzer itself plays an objective role in the patients' careplan: it measures their blood alcohol content, revealing how much theydrank today, and providing a check on the self-reported number of drinksfor the day. The task of using the breathalyzer commands significantattention, even though the app makes its use easy for all, and the tasksof answering the accompanying questions raise issues of reportingaccuracy that are not related to the effect of the medication. Theassociated task of reviewing the trend of objective data over the pastfew weeks also remind patients of the longer term issues of behaviorpast and future, and reporting progress to the medical staff, thatdistract from the impulsive near term reward orientation associated withaddiction.

This presents the ideal context in which to present one additionalrequest: take your medicine. The “take your medicine” request preferablyhas a verification task associated with it, so it cannot easily beignored. In our case, the verification task is automatically presentedby the app, which takes a photograph of the pill in the patients' hand,preparing the medicine for being taken immediately by mouth. Themedicine reminder is performed during the daily ritual of using thebreathalyzer, which enhances adherence by de-emphasizing the medicationreminder compared to the temporally adjacent task (before or after) ofusing the breathalyzer.

The disclosed technology prompts patients to use the app andbreathalyzer once or twice a day depending on the severity of theiraddiction pattern. Using the breathalyzer is a multi-step process,involving turning on the device and perhaps charging it, pairing withBluetooth, warming up, blowing, reading the result, and reading adynamic message for the patient and sometimes reviewing past progress.The breathalyzer use actually provides useful information to the addictthat he can act on independently.

The app keeps track of the results, and provides a useful graphicaldisplay of progress. In comparison, the single step medicine reminder(take the photo now) becomes submerged in the attention paid to thebreathalyzer process. After a week or two of usage, the breathalyzerusage becomes a multistep ritual that can be performed largely withoutthought. The medication reminder becomes a small piece of a differentactivity that is considered useful to the patient. As a result, littleattention is paid to the medication reminder, and positive compliance is“borrowed” from the adjacent task of using the high-tech breathalyzer.

In a further aspect of the invention, the process of taking thephotograph of the pill in the patient's hand further increases adherenceand reduces the opportunity to cheat the system. In order to take thephotograph, the patient must find his pills, open the bottle, and shakeout a pill into his hand. At this point, the patient has completed threeout of the four steps of taking the medicine. After taking the photo thequickest and easiest action available is to complete the action byswallowing the medicine. No medicine adherence tool is foolproof; thisapproach is both convenient and natural, which makes it effective.

In a further aspect of the invention, we provide systems and methods forempowering a spouse or significant supporter in a behavioralmodification treatment program. When harmful behaviors have been learnedby a patient, as is usually the case in substance abuse disorder, eatingdisorder, and other situations such as diabetes, the party whose life ismost impacted is often not the patient, but a spouse or other personwith a significant relationship with the patient. While the patienttolerates and sometimes even promotes his own harmful behavior, thespouse sees his relationship with the patient slowly eroded and suffersreal anguish. Anyone who has attended both Alcoholics Anonymous meetings(for addicts) and Al Anon meetings (for family members of addicts) knowsthat the family members carry most of the the stress and pain caused bythe addiction. These family members and close friends need support asmuch or more than the patient being treated.

An invention we provide is a stress reduction tool that empowers thosein a patient's inner circle. Addiction is characterized by learnedbehaviors that an addict associates powerfully with his substance abuseactions. At and after the ball game, for example, the learned action maybe for the patient and his drinking buddies to drink too much and getinto fights. This behavior is completely predictable for the patient'sspouse, who is far too familiar with the subsequent effects ofintoxication. We provide the spouse with a tool to monitor and reportback data on the intoxication condition of the patient. The spouse canthen take action based upon the data, and the patient can learn tomodify his behavior based upon the requirements of the spouse.

In the case of alcohol abuse, the patient uses a personal wirelessbreathalyzer with a DxRxMedical app to measure his blood alcoholcontent. The patient may use the app to measure his blood alcoholcontent at any time, but a spouse may be remote from the patient andunable to request a breathalyzer measurement. We provide an app for thespouse to use for this purpose. The spouse's app maintainsconfidentiality and limited access with a spouse login procedure. Whenauthorized by the patient, the spouse's app provides a controlfunctionality that allows the spouse to set up a breathalyzer action onthe patient's app. The requested action may be immediate or it may bescheduled for a specific time in the future, such as at a time theballgame is expected to end.

At the scheduled time, the patient receives an alert through the app,which may be a tone or a buzz and a screen instruction to use thebreathalyzer. The breathalyzer measurement result is then communicatedback to the spouse's app and the spouse is alerted to check the resultwhen it is available. The real-time scheduling, communications, andalerting are made possible by the connectivity of the apps through the“cloud” as provided by the DxRx service. Additionally, the patient appmay be configured to display dynamic messages from the spouse. Thespouse may set up a message such as “Reminder: you agreed to skip thebar and come straight home.” that displays if the measured blood alcoholcontent exceeds a threshold set by the spouse such as 0.02 for example.A different message may be set to display if the blood alcohol contentis less than or equal to 0.03 such as “Way to go, John! You did it!”

As a further feature of the breathalyzer measurement requested by aninner circle member, the front facing camera of the mobile device may beactivated, with the prior permission of the patient, and a photograph ofthe patient will be taken at the moment of sampling the patient's breathfor the breathalyzer measurement. The purpose of the photograph is toensure that the breathalyzer data are acquired for the patient and notsome third party. The photograph is displayed to the patient on thepatient's mobile device so that the patient is aware that the photo hasbeen taken, and the system sends a data record to the server includingthe photo data. The photo is also sent to the requesting party to assurethem that the patient used the breathalyzer and not some third party.

In a further aspect of the invention, we provide systems and methods forengaging an inner circle of supporters in the treatment and recovery ofthe patient. It is well known that social interactions with closesupporters provide strong motivation. One of the consequences ofaddictive substances including alcohol and drugs is that addicts tend toabandon their social interactions in favor of obtaining and using theaddictive substance. Rebuilding social connections is one of the mostimportant elements in a recovery treatment program.

We have invented effective methods for establishing or renewing socialconnections, and for promoting frequent interactions with theseconnections. We provide an app functionality for the patient that allowshim to work with supporters he chooses. The patient is encouraged toenroll several supporters in the program to help him with his recovery.A control function is provided in the app that allows him to send anemail inviting his chosen supporters to download their own app. Thecontrol function also allows the patient to set permissions for hissupporters to execute certain functions such as providing weeklybehavior ratings of the patient, and receiving information about theblood alcohol measurements of the patient.

Supporters use the supporter app to receive a weekly alert with arequest for a simple rating of the patient's behavior such asbetter/same/worse, or great/fine/neutral/poor/terrible. The rating isaccomplished easily and in a short time by tapping one of the actionbuttons on the page, and it may be accompanied by one or two additionalquestions. This information is stored in a server connected to thesupporter app and it is also sent to the patient so the patient isreminded that the supporter still cares about his progress. The ratingprocess may be accompanied by an easy messaging facility between thepatient app and the supporter app, allowing the supporter to suggest andarrange a face-to-face meeting, for example. This process reinforces theconnection with the supporter on at least a weekly basis.

Since supporters can also see the breathalyzer measurements for thepatient over time, they are in a position to communicate encouragementto the patient, reminding the patient of the progress being made, andagain reminding the patient that the supporter cares about his progress.These social connections build in the patient's mind over time,ultimately giving him the motivation to undertake behavior changesconsidered difficult such as meeting with a therapist for example.

The system also calculates baseline levels of behavior and behaviortrends from the rating data provided by the patient's supporters.Significant deviations from the current trend may be communicated to thepatient's inner circle of supporters and family members, as allowed bythe patient through his control function. Some deviations are negative,such as a relapse into substance abuse, and the resultant alerts mayenable inner circle members to marshal additional support for thepatient. Other deviations are positive, such as the first meeting withthe therapist, and the alerts provided to the inner circle becomereminders to provide positive feedback.

Disclosed are various systems and methods that implement thesesolutions. For instance, a software solution operates on the server. Aversion of the software is implemented as an iOS or other operatingenvironment app that runs on smartphones. Another version of thesoftware solution is implemented to run on browsers on some of thesmartphones and on desktop or laptop computers.

A patient who is registered in the software solution may access thetreatment solution through his internet connected device which may beany form of internet connected device such as a smartphone, laptop,desktop, tablet, or wearable. A medical team may serve the patient. Themedical team may consist of a variety of specialties includingphysician, midlevel, therapist, coach, and/or counselor. After anonboarding visit between the physician and the patient, in which thepatient is accepted into the physician's practice and a doctor-patientrelationship is established, further communications may proceed in partthrough the treatment solution.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, which are incorporated in and constitute apart of this specification, exemplify the embodiments of the presentinvention and, together with the description, serve to explain andillustrate principles of the invention. The drawings are intended toillustrate major features of the exemplary embodiments in a diagrammaticmanner. The drawings are not intended to depict every feature of actualembodiments nor relative dimensions of the depicted elements, and arenot drawn to scale.

FIG. 1 depicts an example of a perspective view of a substance abusetreatment adherence system;

FIGS. 2A-2B depict examples of perspective views of a substance abusetreatment adherence system;

FIG. 3 depicts an example of a method for implementing a treatmentadherence system;

FIG. 4 depicts an example of a method for sending an alert if the systemdetermines a measurement or compliance metric is outside of a threshold;and

FIG. 5 depicts an example of a method for rating a behavior of a patientand sending an alert if the behavior deviates outside a threshold.

In the drawings, the same reference numbers and any acronyms identifyelements or acts with the same or similar structure or functionality forease of understanding and convenience. To easily identify the discussionof any particular element or act, the most significant digit or digitsin a reference number refer to the Figure number in which that elementis first introduced.

DETAILED DESCRIPTION

Unless defined otherwise, technical and scientific terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art to which this invention belongs. Szycher's Dictionary of MedicalDevices CRC Press, 1995, may provide useful guidance to many of theterms and phrases used herein. One skilled in the art will recognizemany methods and materials similar or equivalent to those describedherein, which could be used in the practice of the present invention.Indeed, the present invention is in no way limited to the methods andmaterials specifically described.

In some embodiments, properties such as dimensions, shapes, relativepositions, and so forth, used to describe and claim certain embodimentsof the invention are to be understood as being modified by the term“about.”

Various examples of the invention will now be described. The followingdescription provides specific details for a thorough understanding andenabling description of these examples. One skilled in the relevant artwill understand, however, that the invention may be practiced withoutmany of these details. Likewise, one skilled in the relevant art willalso understand that the invention can include many other obviousfeatures not described in detail herein. Additionally, some well-knownstructures or functions may not be shown or described in detail below,so as to avoid unnecessarily obscuring the relevant description.

The terminology used below is to be interpreted in its broadestreasonable manner, even though it is being used in conjunction with adetailed description of certain specific examples of the invention.Indeed, certain terms may even be emphasized below; however, anyterminology intended to be interpreted in any restricted manner will beovertly and specifically defined as such in this Detailed Descriptionsection.

While this specification contains many specific implementation details,these should not be construed as limitations on the scope of anyinventions or of what may be claimed, but rather as descriptions offeatures specific to particular implementations of particularinventions. Certain features that are described in this specification inthe context of separate implementations can also be implemented incombination in a single implementation. Conversely, various featuresthat are described in the context of a single implementation can also beimplemented in multiple implementations separately or in any suitablesubcombination. Moreover, although features may be described above asacting in certain combinations and even initially claimed as such, oneor more features from a claimed combination can in some cases be excisedfrom the combination, and the claimed combination may be directed to asubcombination or variation of a subcombination.

Similarly while operations may be depicted in the drawings in aparticular order, this should not be understood as requiring that suchoperations be performed in the particular order shown or in sequentialorder, or that all illustrated operations be performed, to achievedesirable results. In certain circumstances, multitasking and parallelprocessing may be advantageous. Moreover, the separation of varioussystem components in the implementations described above should not beunderstood as requiring such separation in all implementations, and itshould be understood that the described program components and systemscan generally be integrated together in a single software product orpackaged into multiple software products.

Overview

Disclosed are systems and methods for increasing patient compliance witha treatment adherence program. Patients with substance abuse problemsmay be prescribed regular medication that dulls the positive effects ofthe substance. However, one of the largest challenges for substanceabuse patients is that many do not regularly take their medication asthey want to experience the high of the substance. Accordingly, systemsand methods have been developed for medication sessions that distractthe patient from taking the medicine by incorporating the reminder andother med actions in close temporal proximity.

For instance, in some examples, the system includes a measurement deviceand a mobile device. In some examples, the system is set up for a careplan session that includes use of the hardware measurement device and aprompt to take medication in a close temporal proximity to using themeasurement device. The patient's engagement with the measurement devicedistracts the patient from taking the medication. Accordingly, after thepatient is on a regular schedule, the patient forms a habit of using themeasurement device and the medication. Experimental results of theapplication have shown that the system can increase adherence to takingmedication in alcoholics that have a treatment plan to decrease abuse ofalcohol.

For instance, the mobile device may initiate the measurement device, andinstruct the patient to use it. Then, the patient may use themeasurement device (e.g. blow into a breathalyzer), which results aresent to the mobile device and display on the display. Then, the mobiledevice may automatically (within a certain span of time—before orafter—using the measurement device) to take their meds. The system mayalso ask the patient to take a picture of the meds in their hand.

The system will send this data to a server, so that a doctor may reviewon her own mobile device, see the trend of the test results, themedication adherence, and the photos of the medication. Also, the doctormay update or form a new care plan that can be sent to the server ontheir mobile device.

Additionally, the system may link an inner circle of supporters andfamily members, which can rate the patient's behavior, and schedulespecific breathalyzer sessions. The system may also provide a functionof granting permissions enabling the patient to add individuals of hischoice to his inner circle and grant them permissions to rate behaviorand schedule sessions. Also, the patient's mobile device may include acraving alert button that can immediately send an alert to the doctor,the family devices or to both.

In some examples, the server may calculate thresholds (or receive themfrom the doctor) that send out alerts to the doctors and/or inner circlemembers automatically. For instance, after a measurement on a certainday, if the blood alcohol content is above a threshold the system can beset to send out an alert. Additionally, the server may record behaviorratings and determine a trend or threshold of the subject ratings. Then,the system can send a message or notification to family or the doctor ifthe behavior rating is outside of the trend significantly, or outsidethe threshold.

System Connectivity

FIG. 1 illustrates an example system that includes mobile devices 150,for the doctor, patient, and inner circle that are connected over anetwork 180 to a server 115 and database 125. Additionally, ameasurement device 100 is connected to the patient mobile device 150 insome examples by sending a signal (e.g. Bluetooth) between the antennas140. In other examples, the measurement device 100 may connect to themobile device(s) 150 over the network 180 and may for instance be routedthrough the server 115.

The mobile devices 150 include a display 110 (that may be used for aninterface to receive data and display data to a user), a control system120 including one or more processors, a location sensor 190 (e.g. GPS),antenna 140, and memory 130. Additionally, the measurement device 100may include a control system 120, memory 130, and antenna 140.

In some examples, the patient mobile device 150 may include a frontfacing camera 160 and/or a back facing camera 160. For instance, in someexamples, the system will request the patient take a picture with themedication in their hand with the back facing camera 160. In otherexamples, the front facing camera 160 may record the patient takingtheir medicine.

The doctor may have a mobile device 150 connected to the system that canreview data from the patient mobile device 150 stored in the database125. This may include a history of measurement data, photographs, andother information. The system further comprises a set of securityfunctions to restrict access to data to the appropriate parties based ontheir login information and security codes.

Also, a family member (e.g. spouse) may have a mobile device 150 that isconnected to the system over the network 180. In some examples, thefamily device 150 may be able to schedule measurements with themeasurement device 100, receive alerts and perform other functions asdescribed more fully herein. In some examples, the family member mobiledevice 150 may be able to download the measurement data from thedatabase 125.

Additionally, a measurement device 100 may be included for measuring theintoxication of the patient. For instance, in some examples themeasurement device 100 will be a connected breathalyzer. Thebreathalyzer may connect to the patient mobile device 100 throughBluetooth, WiFi, or directly by plugging into a port of the smartphone.

In other examples, the measurement device 100 may be a urine test fordrugs including prescription drugs, opiates, THC, etc. In theseexamples, the device may be connected wirelessly in the various methodsdiscussed to receive the results. Accordingly, in this embodiment, thecare plan and other information may be used to treat an opiateaddiction.

FIG. 2 illustrates an example of a system with various data structures200 that are sent over the network 180 to the various devices of thesystem. For instance, the patient's mobile device 150 may first send adata structure 200 to the measurement device 100 with instructionsinitiate the measurement device 100 (pictured as a breathalyzer butcould also be an opiate urine test, or other test for abusedsubstances).

Then, after the measurement device captures the raw data and processesthe data to output a measurement (e.g. blood alcohol content (“BAC”}),the measurement device 100 sends a data structure 200 packet to thepatient mobile device 150. The data structure 200 includes one or moremeasurements, for instance BAC, opiate levels, or others. Additionally,the data structure 200 may include date and time stamp information.

Once the mobile device 150 receives the data structure 200, it may bestored in the mobile device memory 130. Then, then measurement datastructure 200 may be sent to a server 115 over a network 180. In someexamples, that data structure 200 may also include information regardinga medication session. For instance, it may include whether the patientagreed to take their medication, whether they took a picture, the datafor the picture (or video), and the date and time of the picture.

Additionally, the data structure(s) 200 sent from the patient's mobiledevice (and most data structures sent) may include a patient identifier.The patient identifier may be a code that is referenced to the patientidentifying information in a database 125. Accordingly, as the server115 receives data from mobile devices 150 or other computing devices,the data will be stored and referenced to a specific patient in thedatabase 125.

Each time a new measurement and medication session is initiated, themobile device 150 and/or the server 115 and database 125 may store thesession data as referenced to a session. For instance, a patient careplan may include instructions for a daily or twice daily medication andtesting session. The session data 200 could then be stored referenced tothe care plan expected session.

Accordingly, the session data may be accessed by the server 115 to sendto the various mobile devices 150 or other computing devices connectedto the network 180 for viewing or analyzing to view trends and graphs ofmeasurements. Additionally, the system can determine which days weremissed for measurements or medication based on comparing the measurementand medication data to the care plan data 200.

A doctor computing device 150 may also be connected to the system andsend requests for changes to a care plan, or a request to form a newcare plan. The care plan information may include the patient identifier,the medication plan which will include the medication, dosage, and theday and times for taking the medication. The doctor mobile device 150can send a request to the server 115 to update the plan, change thedosage, frequency, or other portions of the care plan. Then, the server115 will automatically send an update to the patient's mobile device 150that includes the updated or changes to the care plan.

Additionally, the doctor's mobile device 150 will be able to access themeasurement, and medication session data. Additionally, the doctor'smobile device 150 may be able to send messages to the patient, orschedule automatic messages to the patient after certain events. Forinstance, after the patient takes their meds or takes a picture, thedoctor or system can schedule an automatic notification or message tothe patient that congratulates them on taking the medicine that will bedisplayed on the display 110 of the patient' mobile device 150.

The family or friend mobile device 150 may be able to send requests tothe server 115 that are forwarded to the patient's mobile device 150.This may include scheduling a request for measurement at a certain time.For instance, the family (e.g. spouse) mobile device 150 could send adata packet 200 that includes instructions to schedule or notify thepatient for a measurement that is outside of the patient's care planthat may optionally include a threshold BAC or other measurement. Thismay be useful if the patient's spouse knows the patient will be in atrigger environment, for example a sporting event. Then, the patient maybe required to take a measurement at the end of the game.

If the patient does do the measurement near when requested, and themeasurement is over threshold indicated in the data structure 200 fromthe family members mobile device 150, the patient mobile device 150 orserver 115 may send an alert to the family mobile device 150. This alertmay include and indicate that it is over a threshold amount, and mayoptionally include the measurement reading.

The family or rater mobile device 150 may also include an interface forrating the behavior of the patient. In some examples, the server 115 maysend a request to the family/rater mobile device 150 to rate thebehavior of the patient, on a quantitative scale that would be asubjective rating. Then, the family member would enter the rating intothe mobile device 150, which would be sent as a data structure 200 tothe server 115 and stored in a database 125. The data structure 200 mayinclude a day and time data, a rating, and other information including apatient identifier. The rating behavior may be stored in the server 115,referenced to the particular patient. To preserve patient compliancewith the system, it is preferable to include patient control in the formof permissions for people to join his inner circle and provide ratings.The patient permissions can be allocated individually to family members,close friends, authority figures, and others the patient may select tojoin his inner circle as his supporters. Separate permissions may beallocated for different classes of activities, including for exampleproviding periodic behavior ratings and receiving Craving Alerts.

The server 115 and database 125 may also store various permissions andautomatic protocols for sending alerts in various situations. Forinstance, if a measurement, medication session adherence, or behaviorrating is outside of a trend or threshold, the server 115 mayautomatically send alerts based on the protocol stored in the database125 for that particular issue. The patient, doctor, or family mobiledevice 150 may be able to adjust the threshold or setting for sendingautomatic alerts, text messages, or other notifications.

In some examples, those device may be able to set a thresholdmeasurement, behavioral, or other quantitative value for notifications.Also, those device may be able to set the types of notifications theywould like to receive, for instance the family member may only wantnotifications related to measurements and not behavior. Accordingly,these preferences may be stored on a database 125 by the server 115.Therefore, when new measurements, ratings, or other data comes into theserver 115 to be processed, the system can determine whether any alertsshould be issued, and which devices to send the alerts.

Methods—Care Plan Session

FIG. 3 is a flow chart depicting an example method for implementing acare plan session on a smartphone and associated measurement device. Inthis example, the interactions on the interface of the patient's mobilephone 150 are done in close temporal proximity to the interactions touse the measurement device 100. This helps distract the patient from themedication, to increase the patient's compliance with the care plan.

For instance, first a software application running on the control system120 of a patient's mobile device 130 may send a notification to thedisplay 110 for a care plan session that may include either or both of ameasurement and a medication taking session. Then, the user may use theinterface (e.g. display, touchscreen, buttons) to accept or confirm theywould like to begin a session.

If so the application may (or after the medication portion) send a datarequest to the measurement device 100 to initiate a measurement session300. Initializing may include turning on, charging, pairing, warming up,blowing, analyzing or reading out with the device 100. In some examples,the application running on the patient's device 150 may displayinstructions to the patient on the display 110 and also send datapackets 200 with instructions for each step of the measurement device's100 measurement session. In other examples, one initiated by theapplication on the patient's device 150, the measurement device 100 mayfollow a protocol for the measurement.

After the measurement is completed, the measurement device 100 may sendthe measurement data so that measurement data is received 305 by thepatient's mobile device 150. In other examples, the measurement device100 may send the data to the server 115, and the server 115 may send thepatient device 150 an update that the data has been received includingdata with the measurement.

After the measurement data has been received 305, the system willautomatically display a question or other notification to the patient asto whether they will take their meds 310. In other examples, themedication question may be first when the care plan is initiated, andnext after the medication portion is complete the system mayautomatically initiate the measurement protocol.

After the system asks the patient if the patient would like to taketheir meds 310, the patient may confirm or answer yes or no. If thepatient answers no, then the session may terminate and the mobile device150 may send the session data to the server 335. If the patient confirmsor says yes, then the mobile device 150 may prompt the user to take aphoto 315 or provide some other image data.

For instance, the device 150 may request the patient (e.g. through thedisplay 110) take a photo of the pill in the patient's hand 315. If thepatient says no, then the session data will again be sent to the server335. If the patient says yes, then the instructions running on thecontrol system 120 may automatically initiate the camera 320 function onthe mobile device 150. This will allow the user to take a photo whilestill running the care plan session so the patient's session is notinterrupted (which increases adherence).

In some examples, the camera will capture image (still or video) data325 of a patient's hand 315 with a pill in the patient's hand. That way,the patient will have the pill out of the container already, and bequite close to taking the pill. In other examples, a front facing cameramay take a video of the patient consuming the pill—for instance bytaping a few seconds after the patient confirms through the interfacethe patient intends on taking the pill. In other examples, the backfacing camera 160 may be used to take photos or video.

After the medication session is finished, the mobile phone 2150 mayautomatically display a congratulatory notification 330, or an automaticmessage crafted and sent from the doctor mobile device 150.Additionally, the session data will be transmitted to the server 335 bythe patient's mobile device 150.

Methods—Delay Timer

In some examples, a delay timer 340 will be inserted between some of thesteps in the care plan management session. The delay timer 340 may beany timer running on the application of the mobile device 150 run by thecontrol system 120 that introduces a few seconds, 4 second, 5 second, 10second, or any other suitable delay that is not too long between steps.

For instance, the steps of initiating the measurement device 300,pairing the Bluetooth, or other steps may introduce a few second delay.This has been found through research to help adherence by allowing apatient to reflect on their condition and its consequences during thecare plan session protocol. Accordingly, the mobile phone 150application automatically advances the care plan protocol between steps,and the delay timer 340 may put a certain delay between steps. In someexamples, the doctor computing device 150 may be able to adjust thedelay by patient and feedback. In other examples, the patient can turnoff the feature through the interface (e.g. touchscreen) on the patientmobile device 150.

In some examples, the amount of delay may be variable. Accordingly, thedelay may be from 2-5 seconds. The counter could use a base amount of 2seconds, and then use a random number generator to add a random amountof time between 0-3 seconds to the 2 seconds to determine the totaldelay for a given step. The difference in delay may be important to keepthe patient's attention, because the patient will not then get used to acertain delay, and will remain attentive to the device until the delayis finished.

Methods—Alerts Based on Threshold

FIG. 4 illustrates a method the system (e.g. the server control system)may utilize to determine a threshold, and send an alert or message tovarious mobile devices 150 linked to the patient account if thethreshold is crossed. For instance, the system may receive a measurementdata or compliance data 400 that may include measurement amounts and/orinformation representing whether the meds or pictures were taken onparticular days.

Then, the system may receive a measurement or compliance threshold 410from the care team (e.g. doctor mobile device 150). The measurementthreshold may be determined by a doctor and entered into the mobiledevice 150 or may be calculated based on past usage data. For instance,the server 115 may calculate a moving average of the past three weeks.In some examples, that could be for each separate weekday, as substanceabuse may be greater on the weekends. In some examples, the patient orfamily member may enter a threshold into their mobile device 150 whichcould be saved and stored in the database 125, or only on the patientmobile device 150.

Then, when a new measurement is received by the server 115, or datarelating to a medication session is received by the server, that datacould be compared to a stored threshold to determine whether it iswithin the threshold 415. If it is, then the system may do nothing, andcontinue to receive compliance data 400 and calculate new thresholds 410if applicable.

However, if the new compliance data 400 received is not within thethreshold, then the server may send an alert 420. This alert could bemessages sent to the doctor, family member, patient, and otherassociated mobile devices 150 (or a subset as disclosed herein). Thealert may include the various information disclosed herein, includingthe information related to the deviation from the threshold. Forinstance, if the patient does not take their meds for a few days, thesystem could send an alert indicating that the patient has not takentheir meds, and provide an option for the physician to automaticallyrespond with a message that indicates that they should have a call.

In some examples, the system may indicate an alert 420 when the starttime or compliance time follows a trend that is outside of a threshold.Research indicates that when a time for taking medication begins todeviate or get erratic, the patient is less likely to follow through ontheir care plan. Accordingly, the system may record an average starttime for a care plan session, and determine a threshold deviation over acertain number of days when a doctor should be notified. In otherexamples, the threshold may be a window around the care plan set timecreated by the patient on their mobile device 150.

Methods—Alerts Based on Behavior Rating

FIG. 5 illustrates an example of a method implanted by the server 115that sends alerts if the behavior ratings fall outside of a trend—whichcould be positive or negative. For instance, the server 115 may send arequest to a family mobile device 150 or other rater that is associatedwith the patient. The request may include a survey to rate the patient'sbehavior that week, that day or over some other time period.

In some examples, the rater's mobile device 150 may automaticallyrequest the rater to enter in a rating. Additionally, the patient mayindicate which mobile devices and which accounts will rate the patient.

The rating may be a scale of 1 through 5 or other suitable scale thatindicates overall the behavior of the patient. In some examples, therating may be:

1—Terrible 2—Poor 3—Neutral

4—Doing fine

5—Really Great

-   The rating request could be a text message that the rater responds    with 1-5 as an answer. In other examples, it could be an email, or    an automated notification that opens the application on the rater's    mobile phone 150. In other cases the behavior rating may be on a    relative scale: “Evaluate the patient's behavior in the current    period compared to the time of your last rating:-   1. Better-   2. Same-   3. Worse

Then, the rater's mobile device 150 will send the rating data so it isreceived 510 by the server 115. The server 115 may then use the new datato evaluate the trend 520 of the behavior, by determining a baseline oran average rating for that patient for a number of prior weeks and atrend that includes the best fit rate of change. The trend calculationis constrained by the statistical properties of the data, with poorstatistics, i.e. a standard deviation comparable to the rate of changetimes the time period of the data, yielding a flat trend with no rate ofchange. For some patients, they may have two or three raters, and eachof their ratings may be averaged together. In other examples, the server115 may average each rater's rating separately for a certain period oftime to determine a current baseline rating.

Then, if a new behavior rating is received 525 at a future time period,the system may then compare the new rating to the trend to determinewhether the new rating(s) deviate from the trend over a set threshold530. The noise in the rating may be 0.7 points for example, andtherefore, if the current rating is 3.2, the system may not send anotification or alert 535 unless the rating falls below 2.5 or exceeds3.9. The notification is for the purpose of attracting appropriateattention to the change in the behavior rating. Additional informationmay in some cases accompany the notification, as in the example whereimmediate action is indicated based on a specific rating received. Inother cases, the notification of a deviation is sufficient, as aninterested party can query the system database to receive the specificrating received as well as other information.

If the behavior rating is over a threshold 530, then the server 115 maysend an alert 535 to the appropriate mobile devices 150. For instance,the system may only send a notification to the doctor 150, since theraters and the family may already be aware of the behavior. In someexamples, the patient will receive alerts or notifications to reinforceor give support. The message to the doctor's mobile device 150 mayinclude a graph or table of the ratings over a set time period, andallow the doctor to decide how to proceed.

Computer & Hardware Implementation of Disclosure

It should initially be understood that the disclosure herein may beimplemented with any type of hardware and/or software, and may be apre-programmed general purpose computing device. For example, the systemmay be implemented using a server, a personal computer, a portablecomputer, a thin client, or any suitable device or devices. Thedisclosure and/or components thereof may be a single device at a singlelocation, or multiple devices at a single, or multiple, locations thatare connected together using any appropriate communication protocolsover any communication medium such as electric cable, fiber optic cable,or in a wireless manner.

It should also be noted that the disclosure is illustrated and discussedherein as having a plurality of modules which perform particularfunctions. It should be understood that these modules are merelyschematically illustrated based on their function for clarity purposesonly, and do not necessary represent specific hardware or software. Inthis regard, these modules may be hardware and/or software implementedto substantially perform the particular functions discussed. Moreover,the modules may be combined together within the disclosure, or dividedinto additional modules based on the particular function desired. Thus,the disclosure should not be construed to limit the present invention,but merely be understood to illustrate one example implementationthereof.

The computing system can include clients and servers. A client andserver are generally remote from each other and typically interactthrough a communication network. The relationship of client and serverarises by virtue of computer programs running on the respectivecomputers and having a client-server relationship to each other. In someimplementations, a server transmits data (e.g., an HTML page) to aclient device (e.g., for purposes of displaying data to and receivinguser input from a user interacting with the client device). Datagenerated at the client device (e.g., a result of the user interaction)can be received from the client device at the server.

Implementations of the subject matter described in this specificationcan be implemented in a computing system that includes a back-endcomponent, e.g., as a data server, or that includes a middlewarecomponent, e.g., an application server, or that includes a front-endcomponent, e.g., a client computer having a graphical user interface ora Web browser through which a user can interact with an implementationof the subject matter described in this specification, or anycombination of one or more such back-end, middleware, or front-endcomponents. The components of the system can be interconnected by anyform or medium of digital data communication, e.g., a communicationnetwork. Examples of communication networks include a local area network(“LAN”) and a wide area network (“WAN”), an inter-network (e.g., theInternet), and peer-to-peer networks (e.g., ad hoc peer-to-peernetworks).

Implementations of the subject matter and the operations described inthis specification can be implemented in digital electronic circuitry,or in computer software, firmware, or hardware, including the structuresdisclosed in this specification and their structural equivalents, or incombinations of one or more of them. Implementations of the subjectmatter described in this specification can be implemented as one or morecomputer programs, i.e., one or more modules of computer programinstructions, encoded on computer storage medium for execution by, or tocontrol the operation of, data processing apparatus. Alternatively or inaddition, the program instructions can be encoded on anartificially-generated propagated signal, e.g., a machine-generatedelectrical, optical, or electromagnetic signal that is generated toencode information for transmission to suitable receiver apparatus forexecution by a data processing apparatus. A computer storage medium canbe, or be included in, a computer-readable storage device, acomputer-readable storage substrate, a random or serial access memoryarray or device, or a combination of one or more of them. Moreover,while a computer storage medium is not a propagated signal, a computerstorage medium can be a source or destination of computer programinstructions encoded in an artificially-generated propagated signal. Thecomputer storage medium can also be, or be included in, one or moreseparate physical components or media (e.g., multiple CDs, disks, orother storage devices).

The operations described in this specification can be implemented asoperations performed by a “data processing apparatus” on data stored onone or more computer-readable storage devices or received from othersources.

The term “data processing apparatus” encompasses all kinds of apparatus,devices, and machines for processing data, including by way of example aprogrammable processor, a computer, a system on a chip, or multipleones, or combinations, of the foregoing The apparatus can includespecial purpose logic circuitry, e.g., an FPGA (field programmable gatearray) or an ASIC (application-specific integrated circuit). Theapparatus can also include, in addition to hardware, code that createsan execution environment for the computer program in question, e.g.,code that constitutes processor firmware, a protocol stack, a databasemanagement system, an operating system, a cross-platform runtimeenvironment, a virtual machine, or a combination of one or more of them.The apparatus and execution environment can realize various differentcomputing model infrastructures, such as web services, distributedcomputing and grid computing infrastructures.

A computer program (also known as a program, software, softwareapplication, script, or code) can be written in any form of programminglanguage, including compiled or interpreted languages, declarative orprocedural languages, and it can be deployed in any form, including as astand-alone program or as a module, component, subroutine, object, orother unit suitable for use in a computing environment. A computerprogram may, but need not, correspond to a file in a file system. Aprogram can be stored in a portion of a file that holds other programsor data (e.g., one or more scripts stored in a markup languagedocument), in a single file dedicated to the program in question, or inmultiple coordinated files (e.g., files that store one or more modules,sub-programs, or portions of code). A computer program can be deployedto be executed on one computer or on multiple computers that are locatedat one site or distributed across multiple sites and interconnected by acommunication network.

The processes and logic flows described in this specification can beperformed by one or more programmable processors executing one or morecomputer programs to perform actions by operating on input data andgenerating output. The processes and logic flows can also be performedby, and apparatus can also be implemented as, special purpose logiccircuitry, e.g., an FPGA (field programmable gate array) or an ASIC(application-specific integrated circuit).

Processors suitable for the execution of a computer program include, byway of example, both general and special purpose microprocessors, andany one or more processors of any kind of digital computer. Generally, aprocessor will receive instructions and data from a read-only memory ora random access memory or both. The essential elements of a computer area processor for performing actions in accordance with instructions andone or more memory devices for storing instructions and data. Generally,a computer will also include, or be operatively coupled to receive datafrom or transfer data to, or both, one or more mass storage devices forstoring data, e.g., magnetic, magneto-optical disks, or optical disks.However, a computer need not have such devices. Moreover, a computer canbe embedded in another device, e.g., a mobile telephone, a personaldigital assistant (PDA), a mobile audio or video player, a game console,a Global Positioning System (GPS) receiver, or a portable storage device(e.g., a universal serial bus (USB) flash drive), to name just a few.Devices suitable for storing computer program instructions and datainclude all forms of non-volatile memory, media and memory devices,including by way of example semiconductor memory devices, e.g., EPROM,EEPROM, and flash memory devices; magnetic disks, e.g., internal harddisks or removable disks; magneto-optical disks; and CD-ROM and DVD-ROMdisks. The processor and the memory can be supplemented by, orincorporated in, special purpose logic circuitry.

CONCLUSION

The various methods and techniques described above provide a number ofways to carry out the invention. Of course, it is to be understood thatnot necessarily all objectives or advantages described can be achievedin accordance with any particular embodiment described herein. Thus, forexample, those skilled in the art will recognize that the methods can beperformed in a manner that achieves or optimizes one advantage or groupof advantages as taught herein without necessarily achieving otherobjectives or advantages as taught or suggested herein. A variety ofalternatives are mentioned herein. It is to be understood that someembodiments specifically include one, another, or several features,while others specifically exclude one, another, or several features,while still others mitigate a particular feature by inclusion of one,another, or several advantageous features.

Furthermore, the skilled artisan will recognize the applicability ofvarious features from different embodiments. Similarly, the variouselements, features and steps discussed above, as well as other knownequivalents for each such element, feature or step, can be employed invarious combinations by one of ordinary skill in this art to performmethods in accordance with the principles described herein. Among thevarious elements, features, and steps some will be specifically includedand others specifically excluded in diverse embodiments.

Although the application has been disclosed in the context of certainembodiments and examples, it will be understood by those skilled in theart that the embodiments of the application extend beyond thespecifically disclosed embodiments to other alternative embodimentsand/or uses and modifications and equivalents thereof.

In some embodiments, the terms “a” and “an” and “the” and similarreferences used in the context of describing a particular embodiment ofthe application (especially in the context of certain of the followingclaims) can be construed to cover both the singular and the plural. Therecitation of ranges of values herein is merely intended to serve as ashorthand method of referring individually to each separate valuefalling within the range. Unless otherwise indicated herein, eachindividual value is incorporated into the specification as if it wereindividually recited herein. All methods described herein can beperformed in any suitable order unless otherwise indicated herein orotherwise clearly contradicted by context. The use of any and allexamples, or exemplary language (for example, “such as”) provided withrespect to certain embodiments herein is intended merely to betterilluminate the application and does not pose a limitation on the scopeof the application otherwise claimed. No language in the specificationshould be construed as indicating any non-claimed element essential tothe practice of the application.

Certain embodiments of this application are described herein. Variationson those embodiments will become apparent to those of ordinary skill inthe art upon reading the foregoing description. It is contemplated thatskilled artisans can employ such variations as appropriate, and theapplication can be practiced otherwise than specifically describedherein. Accordingly, many embodiments of this application include allmodifications and equivalents of the subject matter recited in theclaims appended hereto as permitted by applicable law. Moreover, anycombination of the above-described elements in all possible variationsthereof is encompassed by the application unless otherwise indicatedherein or otherwise clearly contradicted by context.

Particular implementations of the subject matter have been described.Other implementations are within the scope of the following claims. Insome cases, the actions recited in the claims can be performed in adifferent order and still achieve desirable results. In addition, theprocesses depicted in the accompanying figures do not necessarilyrequire the particular order shown, or sequential order, to achievedesirable results.

All patents, patent applications, publications of patent applications,and other material, such as articles, books, specifications,publications, documents, things, and/or the like, referenced herein arehereby incorporated herein by this reference in their entirety for allpurposes, excepting any prosecution file history associated with same,any of same that is inconsistent with or in conflict with the presentdocument, or any of same that may have a limiting affect as to thebroadest scope of the claims now or later associated with the presentdocument. By way of example, should there be any inconsistency orconflict between the description, definition, and/or the use of a termassociated with any of the incorporated material and that associatedwith the present document, the description, definition, and/or the useof the term in the present document shall prevail.

In closing, it is to be understood that the embodiments of theapplication disclosed herein are illustrative of the principles of theembodiments of the application. Other modifications that can be employedcan be within the scope of the application. Thus, by way of example, butnot of limitation, alternative configurations of the embodiments of theapplication can be utilized in accordance with the teachings herein.Accordingly, embodiments of the present application are not limited tothat precisely as shown and described.

1. A system for implementing a treatment program adherence protocol, thesystem comprising: a measurement device, the measurement devicecomprising: a sensor configured to output measurement data; a memorycontaining machine readable medium comprising machine executable codehaving stored thereon instructions; a control system, comprising onemore processors, the control system configured to execute the machineexecutable code to cause the control system to: receive, from the mobiledevice a data structure with instructions to initiate a measurementcalculate an intoxication level based on the measurement data; and senda measurement data structure to a mobile device comprising datarepresenting the intoxication level; a mobile device, the mobile devicecomprising: a memory containing machine readable medium comprisingmachine executable code having stored thereon instructions; a display acontrol system with one or more processors, the control systemconfigured to execute the machine executable code to cause the controlsystem to: initiate a measurement session, the measurement sessioncauses the control system to: send, the data structure with instructionsto initiate a measurement to the measurement device; receive, from themeasurement device, the measurement data structure; and send, to aserver, the measurement data structure; initiate, in close temporalproximity to the measurement session, a medication session, themedication session causes the control system to: initiate a reminder onthe display to ask the patient whether they took their medication todayas prescribed; receive, through the interface, the patient's response tothe reminder; and send, to a server, a care plan session data structurethat includes a date and time stamp, and information representing thepatient's response to the reminder.
 2. The system of claim 1, whereinthe patient's response to the reminder comprises one or more of thefollowing: an input through the interface that represents a response toa question displayed on the display, an input representing a contact ofthe patient in a defined area of the display, a motion pattern detectedby a motion sensor related to swallowing of a pill, or audio data thatrepresents a sound related to swallowing a pill.
 3. The system of claim1, wherein the patient's response to the reminder comprises audio datarelated to the patient speaking a confirmation they have taken a pill.4. The system of claim 1, wherein in close temporal proximity furthercomprises after the measurement session.
 5. The system of claim 1,wherein the control system is further caused to: display, on thedisplay, the intoxication level.
 6. The system of claim 1, wherein inclose temporal proximity further comprises before the measurementsession.
 7. The system of claim 1, wherein the control system is furtherconfigured to initiate the measurement session at regular intervals. 8.The system of claim 1, wherein the control system is further configuredto initiate the medication session at regular intervals.
 9. The systemof claim 1, wherein the medication session further causes the controlsystem to: initiate a request for patient photo input as to whether thepatient is ready to take a photo of the medication; receive, the patientphoto input and determine whether the camera function would beinitiated; and if the camera function is initiated, take a photographonce patient instructions are received through an interface to take aphotograph.
 10. The system of claim 9, wherein the medication sessionfurther causes the control system to send the image data representingthe photograph to the server.
 11. The system of claim 1, wherein themeasurement device is a breathalyzer.
 12. The system of claim 1, whereinthe measurement device is a urine based drug test.
 13. The system ofclaim 1, wherein the step of sending the data structure withinstructions to initiate the measurement to the measurement devicefurther comprises delaying sending the data structure a preset amount oftime determined using a counter running on the control system.
 14. Thesystem of claim 13, wherein the preset amount of time is between two andfive seconds.
 15. The system of claim 14, wherein the counter uses afixed time of two seconds, and adds a variable amount of time eachsession based on a random number generator that generates a numberbetween zero and three seconds.
 16. A system for implementing atreatment program adherence protocol, the system comprising: ameasurement device, the measurement device comprising: a sensorconfigured to output measurement data; a memory containing machinereadable medium comprising machine executable code having stored thereoninstructions; a control system, comprising one more processors, thecontrol system configured to execute the machine executable code tocause the control system to: receive, from the mobile device a datastructure with instructions to initiate a measurement calculate anintoxication level based on the measurement data; and send a measurementdata structure to a mobile device comprising data representing theintoxication level; a mobile device, the mobile device comprising: amemory containing machine readable medium comprising machine executablecode having stored thereon instructions; a display a control system withone or more processors, the control system configured to execute themachine executable code to cause the control system to: initiate ameasurement session, the measurement session causes the control systemto: send, the data structure with instructions to initiate a measurementto the measurement device; receive, from the measurement device, themeasurement data structure; send, to a server, the measurement datastructure and a date and time stamp for the measurement data structure;a server, the server comprising: a memory containing machine readablemedium comprising machine executable code having stored thereoninstructions; a control system with one or more processors, the controlsystem configured to execute the machine executable code to cause thecontrol system to: receive, a reporting approval data structureindicating a third party mobile device that is pre-approved to receivemeasurement data session information; receive the measurement datastructure and the data and time stamp from the mobile device; and send aset of reporting data comprising measurement data structure to the thirdparty mobile device.
 17. The system of claim 16, wherein the set ofreporting data further comprises the date and time stamp.
 18. The systemof claim 16, wherein a second third party mobile device sends a requestto the server for measurement data structures and wherein the secondthird party mobile device receives historical measurement data if theserver contains a second reporting approval data structure for thesecond third party mobile device.
 19. The system of claim 16, whereinthe third party mobile device is associated with a personal profilestored in a database connected to the server that is a coach, physician,or therapist.